Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Funnel Chest”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1993

Long-term results after operation for funnel chest.

The cases of 36 out of 62 patients who underwent surgical correction of funnel chest deformity between 1978 and 1988 with an average follow-up of 7.6 years were reviewed. The mean age at which the Hegemann operation was performed was 14.1 years. Preoperative cardiorespiratory disorders were reported by 76% of patients, while 71% showed electrocardiographic and pulmonary alterations. Post-operatively, cardiorespiratory disorders were significantly reduced, but the electrocardiographic changes were not. The pre- and postoperative radiological and functional measurements of the chest deformity which allow an objective evaluation of the surgical result are described. Surgical treatment is indicated in most cases of funnel chest deformity, for cosmetic or psychological reasons. The long-term results were good or fair in 90% or more of our cases. We suggested that disfiguring scars with keloid formation cause less psychological distress than persistent congenital malformation of the chest.

Adolescent↗
PubMed1983

Deformities of the female breasts after surgery for funnel chest.

A follow-up study of patients who had undergone surgery for funnel chest in the period 1962 to 1980 revealed that the operation had been performed for cosmetic reasons on four prepubertal girls. A bow-shaped inframammary incision had been attempted in all cases. At follow-up examination, 13 to 17 years later, the scars were situated across the breasts in all four patients. Scars after a pleural drain and removal of the Sulamma struts could also be seen in two of the patients. One patient had undergone plastic surgery for reconstruction of both breasts. In all operative procedures on the thorax in children, a distance of 3 to 5 cm from the areola should be maintained, depending on the patient's age, in order to avoid damage to breast tissue. In particular, it would seem advantageous to employ a vertical sternal incision at operation for funnel chest.

Adolescent↗
PubMed1988

[Clinical aspects and problems of pigeon breast and funnel chest].

Chest wall protrusion and depression deformities, also known as funnel chest and pigeon chest, are nosologically a uniform entity. Our own histopathological studies revealed secondary changes, found likewise in arthroses, scolioses, aseptic osteonecroses and inflammatory processes, as well as changes found in so-called primary collagenous diseases of unknown aetiology. Investigation of the collagen metabolism did not disclose differences from the normal II-type collagen either qualitatively or quantitatively. The aetiology of funnel chest and pigeon chest can be defined as follows: A hereditary disturbance of metabolism results in weakening of the wall of the parasternal cartilage, effecting a deformation secondary to mechanical strain by respiration and growth. Psychocosmetic reasons are recognised as indication for operation. In our opinion, the optimal age for operation is the second to the sixth year of life. During 20 years, 765 patients were operated on at our hospital without lethality. Postoperative complications were pneumothorax (4%), pneumonia (2%), after bleeding (2%) and disturbed wound healing (7%). Late results 5 years following surgery were excellent in 57%, good in 27%, satisfactory in 10% and unsatisfactory in 6% of the cases, thus adding up to 84% good results.

Cartilage↗
PubMedDate not supplied

[The effect of ascorbic acid on the collagen synthesis in skin fibroblasts of children with funnel chest].

Relative synthesis of collagen was studied in skin fibroblasts of children with funnel chest and of corresponding age children (control) in presence of ascorbic acid. In presence of ascorbic acid the rate of collagen synthesis was 2-2.4-fold lower that in corresponding controls both in proliferating and stationary cultures. At the same time, relative synthesis of collagen was quite similar both in the patient and control fibroblasts in presence of ascorbic acid. Estimation of the 14C-Hypro/14C-Pro ratio in collagens isolated from cultural media showed that there was no difference in the hydroxylation rate of collagens in control and patient fibroblasts. These data suggest that funnel chest is one of the forms of systemic connective tissue diseases, which impaired mainly the cartilages.

Ascorbic Acid↗
PubMed1993

[Postoperative lung function in patients with funnel chest].

We evaluated the postoperative lung function determined by spirometry in 54 patients with funnel chest (48 males and 6 females: age range, 4-18 years). Thirty-one patients had sternal turnover as corrective surgery, while 23 had sternal elevation with absorbable PLA (polylactic acid) strut. The mean value of vital capacity as a percentage of predicted (%VC) was 97.3% before operation. %VC was decreased at 3 months (80.5%), 6 months (87.4%), 12 months (82.8%), 24 months (85.9%), and 36 months (77.7%) after the operation (p < 0.01). In patients who had sternal elevation, %VC was decreased at 3 months but not at 6 months, 12 months, 24 months, or 36 months after the operation, while %VC was decreased at any point after the operation in patients who had sternal turnover. No significant changes were seen in forced expiratory volume in one second as a percentage of predicted (FEV1.0%), nor in the ratio of residual volume to total lung capacity (RV/TLC). In conclusion, sternal elevation with PLA strut is a better corrective surgery for funnel chest than sternal turnover, because of its less lung function loss after the operation.

Adolescent↗
PubMed1987

An evaluation of operative outcome in patients with funnel chest diagnosed by means of the computed tomogram.

A questionnaire survey of 66 patients with funnel chest who underwent corrective surgical procedures by the sternal elevation method, with or without the application of metal strut, demonstrated that the operative result was good in 60.6% and fair in 39.4%. None of the patients rated the result as unsatisfactory. A computed tomogram of the chest wall was performed to study the depression (b/c), asymmetry (b'/b), and flatness (a/b) of the chest wall, where a was the maximum transverse distance of the chest wall, b and b' were the maximum distance from the anterior to the posterior chest wall at the left and right sides (b greater than b'), and c was the perpendicular distance from the point of the anterior chest wall at its greatest deformity to the level of the anterior tip of the spine. In patients with a good result, b/c and b'/b were well corrected, while in patients with a fair postoperative result, they were still significantly different from those in subjects with normal chest walls. Moreover, 85.7% of the patients (6/7) with b/c over 3.0 before operation had a fair postoperative result. The degree of a/b was not corrected in patients with either good or fair postoperative results. We conclude that an operative approach to lengthen ribs would be necessary to improve the degree of a/b, that in patients with severely depressed funnel chest, expressed as a b/c value over 3.0 by computed tomography, a transient support with struts should be applied, and finally, that a more careful approach for correction of asymmetry should be undertaken to improve the operative results.

Adolescent↗
PubMed1985

[Objectivization of psychosocial characteristics in chronic physical deformities. Example: Funnel chest--results of an integrative diagnosis].

In a thorough investigation of 164 characteristics (sequelae) in 41 patients with funnel chest, the fundamentals of a method for "integrating diagnosis" are presented. The symptoms "funnel chest" can be of varied significance, according to the degree of deformity, ranging from a severe handicap to a cosmetic fault. This paper suggests a possible way of objectivating the symptoms, which are often only subjective or only indirectly correlated with the basic illness. Such (psychosocial) stress increases with increasing age, or rather with increasing self-reflection. In these patients, one finds, among other symptoms, reduced capacity for exertion, inhibition of autonomous tendencies, poor estimation of their appearance, subjective feelings of stigma, exaggerated suggestibility, orientation towards failure, fear, and specific shame reactions. The formation of these reactions has a concrete effect on all essential aspects of the patient's way of life. It is recommended that the term "cosmetic indication" be no longer used in diagnosis, and that specific psychotherapeutic measures, as well as operative correction, should as a rule be carried out.

Adolescent↗
PubMed1964

[FUNNEL CHEST].

Explore the source record for details and available documents.

Funnel Chest↗
PubMed1992

[Surgical indications of funnel chest].

Pathological findings in ECG represent indications for operation only if they are accompanied by subjective complaints and psychogenic problems. The extent of the abnormality usually does not correlate with the patient's complaints. Disappearance of such complaints after surgery does not be considered as a sign of successful surgery. Even a deep funnel chest is not necessarily an indication for operation if the patient has no complaints and can manage the situation. A flat funnel chest should not be operated on. The operation can be performed in patients between 4 and 24 years of age. If severe associated anomalies require operation as well, the choice is not for correction of the funnel chest first.

Child↗
PubMed1951

Funnel chest (pectus excavatum) in infancy and adult life.

Funnel chest, unless corrected, may lead to cardiorespiratory distress or psychic problems or both. Since operation to correct the deformity is relatively simple in infancy and much more extensive if done later, early surgical intervention is indicated. If the condition is not noted until the patient is beyond infancy, cardiorespiratory studies will aid in determining the advisability of operation.

Adult↗
PubMed1989

[Delayed results in function following funnel chest operation].

34 out of 106 patients with funnel chest treated by operation with an average follow-up of 18 years have been reviewed. In 30% of the patients investigated disturbance of the cardiorespratory system were found preoperatively. There was no significant change of the elektrocardigraphic and pulmonal function due to operation. According to the results the indications for operative treatment under functional and cosmetic aspects are discussed.

Adolescent↗
PubMed1984

[Conservative and operative treatment of the funnel chest].

For the last 30 years, interest in chest wall anomalies has been growing. On the one hand physicians and patients were seeking advice and help from specialists, whereas on the other hand the media devoted more time and space to this subject. The present contribution deals with the funnel chest (cobblers' chest). In infancy the funnel chest can be treated in a conservative way. The favourable age periods for surgical treatment are between 6 and 8 and after 12 years of age. We reached this conclusion on the basis of 171 follow-up examinations of patients during the period 1966-1982.

Adolescent↗
PubMed1995

[Anesthesia for funnel chest operation].

The incidence of perioperative complication and days of hospital stay were studied in 56 patients with funnel chest operation under inhalational anesthesia (18 cases), intravenous anesthesia (23 cases) and epidural anesthesia (15 cases). Perioperative complication occurred most frequently in the inhalational group and was followed by intravenous and epidural group. Postoperative hospitalization on an average was 21.4 days in the inhalational group, 21.9 days in the intravenous group and 16.7 days in the epidural group. It is said that postoperative pain leads to splinting of the chest, which can cause atelectasis and/or pneumonia. Severe postoperative pulmonary complication was reduced in the epidural groups. As a result, hospitalization in the epidural group was shorter than in other groups. This study suggests that epidural anesthesia is more advantageous for funnel chest operation because epidural anesthesia has protective action against arrhythmia and postoperative pulmonary complication.

Adolescent↗
PubMed2003

[Minimally invasive funnel chest correction: initial experiences and critical evaluation of this fascinating technique].

The discussion about the surgical correction of funnel chest deformities enjoys a great renaissance since D. Nuss presented a new, minimal invasive technique. Although his method has gained wide acceptance among patients and pediatric surgeon the question arises, whether it can be considered as the Golden Standard' already. In 2000-2001 a total of 14 patients were corrected by transthoracic implantation of the pectus bar and subsequent elevation of the deformity. Results (mean data): age 14.3 years body weight 54 kg, height 170 cm, operative time 57 min, minimal blood loss, no intraoperative complications. The cosmetic result was considered as very good by all patients on the day of dismission. As a late complication one bar dislocated and had to be repositioned surgically. The minimal invasive approach for funnel chest corrections is a fascinating technique, which demonstrates striking advantages for the children: reduced operative trauma (no rib resections), shorter recovery, small incisions. However only few studies validate the long-term benefit of this procedure. Consequently, the minimal invasive method should not be advocated as the new Golden Standard', until these results meet the high quality of the conventional technique.

Adolescent↗
PubMed1981

[Long term results after funnel chest reconstruction (author's transl)].

The results of 25 funnel chest operations are reported. All patients have been treated by a modified Ravitch method. Fixation of the anterior chest wall was achieved by inserting two metal wires. Cosmetic and functional results were critically examined postoperatively. For clinical assessment the cardiorespiratory and ergometric tests were analysed. Cosmetic results were graded by the classification of Hecker. All patients showed a very good cosmetic result. The functional situation could be improved only partially.

Adolescent↗
PubMed2002

[Inversely planned intensity modulated radiotherapy for irradiation of a woman with breast cancer and funnel chest].

BACKGROUND: A 44-year old woman with breast cancer was transferred to our institution for irradiation. Due to a pronounced funnel chest no satisfying dose distribution was obtained by conventional techniques. Thus an intensity-modulated radiotherapy (IMRT) based on inverse optimisation was carried out. IMRT was compared to conventional techniques regarding dose distribution and feasibility. PATIENT AND METHODS: Tumor site was in the right middle lower quadrant. Target volume included the right breast and the parasternal lymph nodes. Target dose was 50.4 Gy. Based on inverse optimisation irradiation was carried out in "step-and-shoot"-technique with twelve intensity modulated beams with six intensity steps. Additionally, treatment plans were calculated using conventional techniques (technique A with two tangential wedged 6-MV photon beams, technique B with additional oblique 15-MeV electron portal). We analysed conformality and homogeneity of target volume and dose distribution within normal tissue. RESULTS: Dose conformality was substantially improved by IMRT. Dose homogeneity was slightly decreased compared to technique A. Lung volume irradiated with a dose higher than 20 Gy was reduced from 56.8% with technique A and 40.1% with technique B, respectively to 22.1% with IMRT. Treatment was tolerated well by the patient without relevant side effects. Mean treatment time was 19.5 min. CONCLUSION: The inversely planned IMRT using multiple beam directions is suitable for breast irradiation following breast conserving surgery. In the present case of a woman with funnel chest lung dose was substantially reduced without reduction of target dose. In which was the complex treatment technique leads to a clinically detectable advantage is examined at present, in the context of a study.

Adult↗